Epidemiology, Demography and

Biometry Program
National Institute on Aging,
National Institutes of Health, USA
http://www.nih.gov./nia
http://www.nih.gov/nia/research/intramural/

Richard Havlik, M.D., M.P.H.

Associate Director
Learning Objectives:

• To become familiar with the epidemiology

programs of the National Institute on Aging
(NIA)
• To understand the investigations being
conducted by the Epidemiology,
Demography, and Biometry (EDBP) Program,
part of the Intramural Research Program,
(NIA)
• To be aware of data resources available for
the study of the epidemiology of aging and
age-associated diseases
Performance Objectives:

• Monitor appropriately and update knowledge

regularly concerning epidemiology programs at
the NIA
• Become more knowledgeable about the
epidemiology of aging and age-associated
diseases by accessing information from the EDB
Program, NIA
• Begin to access data sets available at the
National Archive of Computerized Data on Aging
and use for relevant epidemiologic analyses
National Institute
 on Aging
 24

22 65,604,000

20
18

16

14
Percent

12
31,559,000
25,704,000
10
8 12,397,000
6 6,459,050
4

1900 10 20 30 40
50 60 70 80 90
2000 10 20 30
Projected
Epidemiology, Demography, and
Biometry (EDB) Program Primary
Mission:
To conduct research on aging and age-
associated diseases and conditions using
population-based epidemiologic and biometric
methods
 EDP Program
Part 1

Epidemiology, and Neuroepidemiology

Demography of Aging Office
Office • Dementing
• Chronic Diseases Processes
• Aging Processes • Risk Factors for
• Environmental, Dementia
Social, and • Other
Behavioral Factors Neuropsychiatric
Diseases
 EDB Program
Part 2

Geriatric
Epidemiology Biometry
Office Office
• Gerontological • Methods
Issues • Statistics
• Biomedical and • Data
Comorbidity Factors Management
• Genetic and
Metabolic Factors
Utility of EDB Program Studies

• Elucidate the etiology of diseases by

combining epidemiologic data with
information from other disciplines.
• Evaluate the consistency of
epidemiologic data with etiologic
hypotheses developed either clinically
• or experimentally.
Provide the basis for developing and
evaluating preventive new procedures
and public health practices.
 Key Guiding Research Principles
Studies should:
• Be platforms for hypothesis –driven research
• Be population based to minimize bias and maximize
relevance
• Be longitudinal in nature to minimize cross-sectional
biases
• Address a wide range of psychosocial and biomedical
issues, including the incorporation of emerging
biological and genetic opportunities
• Attempt to secure data from earlier in life to assess
long-term influences
• Take advantage of racial diversity and unique
populations for investigation
EDB Program Targets
Behavior\
Environment

Age-
Associated
Diseases &
Conditions

Cognitive Physical
Function Function &
& Disability
Dementi
a Genetics
 EDB Program: Targets of Studies

Physical Cognitive Diseases &Genetics/Behavior/

Function &Function &Conditions Poly- Environ-
Disability Dementia morphisms ment
EPESE X    

HAAS  X  X

WHAS X  X  

VSMA X X 

HEALTH ABC X  X  
ACT   X
AGES - Hawaii (Diabetes) X X 
AGES - Reykjavik (Iceland)
 X X X 

X = Primary Focus  = Secondary

 EDB Program: Major Studies

1980 1985 1990 1995 2000 2005 2010

EPESE
HAAS
WHAS
VSMA

HEALTH ABC
ACT
AGES - Hawaii (Diabetes)
AGES - Reykjavik (Iceland)
 Established Populations for Epidemiologic
Studies of the Elderly (EPESE)

East Boston, 1982-83

Senior Health Project
(N=3809)

Iowa 1982
Epidemiology, Demography,
85+ Rural Health Study
and Biometry Program
(EDBP) (N=3673)
New Haven 1982
National Institute Yale Health and Aging
on Aging (NIA) Project
(N=2812)
North Carolina 1986-87
Piedmont Health Survey
of the Elderly
(N=4163)
 EPESE Study Design
Sample: Total or random samples of
community populations of men
and women age 65 and over
Number of Participants
at Baseline: 14,450
Follow-up: In-home interview 3-year
intervals,brief telephone contact
intervening years. Blood work and
performance measures.
(Original sites 1982-83 to
1989)
(Duke 1986-87 to 1993)
Surveillance with Medicare
and
Women’s Health and Aging Study

Focus: Causes and Course of Disability

• Screened 5000 for 1002 Disabled Older Women in
Community
• Assessment of Baseline Disease-Disability
Associations
• Follow-up for Course and Outcome over 5 years
 Honolulu-Asia Aging Study
• A Study of Dementia in Honolulu Heart
Program Participants
• 3734 Japanese-American Men Aged 70-90
years
• 25 Years of Prospective Data Available,
Focused on Cardiovascular Disease and
Other Risk Factors
• Completed Dementia Re-examinations at 3, 5
and 7 Years; On-going Examination Cycle
• Coordinate Methods with Studies in Japan,
Seattle
 Health, Aging and Body Composition
(Health ABC)
Design: Clinical research study
3,075 persons age 70-79
Comparable numbers of women and men
Comparable numbers of whites and African-Americans
Free of ADL disability
Free of functional limitation

Outcome:New onset of functional limitation

Decline in performance, strength and endurance

Follow-up:Seven years with yearly examinations

 Country-to-Country Activities

Collaboration with:
• MRI Study in 10 European Communities (study of
Cardiovascular Determinants of Dementia-CASCADE)
• Honolulu-Asia Aging Study (dementia in Japanese-
American men) and with similar studies in Seattle,
Washington and Hiroshima, Japan (Ni-Hon-Sea Study)
• Aging project of the Veneto Region (PROVA Study)
using protocols similar to those of EDB Program
• Italian Longitudinal Study on Aging (ILSA) has cohort
under observation since 1991
Planned Collaboration with the Iceland Heart Association -
Reykjavik Study
Scientific strategy:
Characterize study participants with detailed phenotypes for:
Neurologic diseases (cognition, Alzheimer’s and
Parkinson’s), atherosclerotic status, diabetes
and
hyperglycemia, obesity and body composition,
and
Collect DNA and other biologic specimens for molecular markers
osteoporosis
Add unique risk factors to the database: birthweight, childhood
weight, and dietary factors
Test relevant candidate genes for genetic susceptibility,
gene-environment and gene-gene interaction
 National Archive of
Computerized Data on Aging
(NACDA)
• Mission is to advance research on aging by
helping researchers gain access to archived
data sets.
• Located at the University of Michigan and is a
project of the Inter-university Consortium for
Political and Social Research (ICPSR)
• For further information: http://www.icpsr.
umich.edu/NACDA